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Abstract
Background: Breast cancer remains a significant public health concern, making prevention strategies crucial. This study assessed women’s knowledge, practices, and attitudes towards breast cancer prevention.
Methods: A quantitative survey using a one-group pre-test and post-test design was conducted.
Results: The results showed that the women surveyed had a good level of knowledge about breast cancer and its risk factors. However, they lacked knowledge about healthy food choices, serving portions, and recommended caloric intake. Despite their positive attitudes towards mammogram screenings, many women did not engage in regular screenings. Factors such as fear, inconvenience, and lack of access to healthcare resources hindered the translation of positive attitudes into action.
Conclusion: The study highlights the need for targeted interventions to bridge the gap between knowledge and practice in breast cancer prevention. Educational initiatives, improved access to mammogram screenings, and efforts to alleviate fear and inconvenience barriers can enhance the effectiveness of preventive measures in reducing breast cancer morbidity and mortality.
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References
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- Bray, F., Ren, J. S., Masuyer, E., & Ferlay, J. (2013). Global estimates of cancer prevalence for 27 sites in the adult population in 2008. International journal of cancer, 132(5), 1133-1145. https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.27711
- Butler LM, Wu AH, Wang R, Koh W-P, Yuan J-M, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 2010;91(4):1013-1019. https://ajcn.nutrition.org/
- Centers for Disease Control and Prevention (CDC. (2011). School health guidelines to promote healthy eating and physical activity. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 60(RR-5), 1. https://stacks.cdc.gov/view/cdc/6024
- Collaborative Group on Hormonal Factors in Breast Cancer. (2012). Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. The lancet oncology, 13(11), 1141-1151. https://www.sciencedirect.com/science/article/pii/S1470204512704254
- DeSantis, C., Ma, J., Bryan, L., & Jemal, A. (2014). Breast cancer statistics, 2013. CA: a cancer journal for clinicians, 64(1), 52-62. https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21203
- Ewertz, M., Jensen, M. B., Gunnarsdóttir, K. Á., Højris, I., Jakobsen, E. H., Nielsen, D., ... & Cold, S. (2010). Effect of obesity on prognosis after early-stage breast cancer. Journal of Clinical Oncology, 29(1), 25-31. https://ascopubs.org/doi/pdfdirect/10.1200/jco.2010.29.7614
- Fan, L., Strasser-Weippl, K., Li, J. J., St Louis, J., Finkelstein, D. M., Yu, K. D., ... & Goss, P. E. (2014). Breast cancer in China. The lancet oncology, 15(7), e279-e289. https://doi.org/10.1016/S1470-2045(13)70567-9
- Ferlay, J., Héry, C., Autier, P., & Sankaranarayanan, R. (2010). Global burden of breast cancer. In Breast cancer epidemiology(pp. 1-19). Springer, New York, NY. http://ndl.ethernet.edu.et/bitstream/123456789/48503/1/3439.pdf#page=13
- Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359-E386. https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.29210
- Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., ... & Bray, F. (2012). Lyon, France: International Agency for Research on Cancer; 2013. Cancer Incidence and Mortality Worldwide: IARC CancerBase, (10).
- Ginsburg, O., Bray, F., Coleman, M. P., Vanderpuye, V., Eniu, A., Kotha, S. R., ... & Gralow, J. (2017). The global burden of women’s cancers: a grand challenge in global health. The Lancet, 389(10071), 847-860. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191029/
- Hemminki, K., Mousavi, S. M., Sundquist, J., & Brandt, A. (2011). Does the breast cancer age at diagnosis differ by ethnicity? A study on immigrants to Sweden. The oncologist, 16(2), 146-154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228093/
- Ibrahim, E. M., & Al-Homaidh, A. (2011). Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Medical oncology, 28(3), 753-765. DOI:10.1007/s12032-010-9536-x
- Leong, S. P., Shen, Z. Z., Liu, T. J., Agarwal, G., Tajima, T., Paik, N. S., ... & Foulkes, W. D. (2010). Is breast cancer the same disease in Asian and Western countries?. World journal of surgery, 34(10), 2308-2324. https://link.springer.com/content/pdf/10.1007/s00268-010-0683-1.pdf
- Li, Y., Zhang, T., Korkaya, H., Liu, S., Lee, H. F., Newman, B., ... & Sun, D. (2010). Sulforaphane, a dietary component of broccoli/broccoli sprouts, inhibits breast cancer stem cells. Clinical Cancer Research, 1078-0432. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862133/
- Lin, C. H., Chen, Y. C., Chiang, C. J., Lu, Y. S., Kuo, K. T., Huang, C. S., ... & Cheng, A. L. (2012). The emerging epidemic of estrogen‐related cancers in young women in a developing Asian country. International journal of cancer, 130(11), 2629-2637. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.26249
- Liu, L., Zhang, J., Wu, A. H., Pike, M. C., & Deapen, D. (2012). Invasive breast cancer incidence trends by detailed race/ethnicity and age. International journal of cancer, 130(2), 395-404. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.26004
- Liu, X., & Lv, K. (2013). Cruciferous vegetables intake is inversely associated with risk of breast cancer: a meta-analysis. The Breast, 22(3), 309-313. https://www.sciencedirect.com/science/article/pii/S0960977612001646
- Lynch, B. M., Neilson, H. K., & Friedenreich, C. M. (2010). Physical activity and breast cancer prevention. In Physical activity and cancer (pp. 13-42). Springer, Berlin, Heidelberg. DOI: 10.1007/978-3-642-04231-7_2
- Naderimagham, S., Alipour, S., Djalalinia, S., Kasaeian, A., Noori, A., Rahimzadeh, S., ... & Farzadfar, F. (2014). National and sub-national burden of breast cancer in Iran; 1990-2013. Archives of Iranian Medicine (AIM), 17(12). http://journalaim.com/Article/747
- Nelson, H. D., Zakher, B., Cantor, A., Fu, R., Griffin, J., O'meara, E. S., ... & Mandelblatt, J. S. (2012). Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Annals of internal medicine, 156(9), 635-648. https://doi.org/10.7326/0003-4819-156-9-201205010-00006
- Norat, T., Aune, D., Chan, D., & Romaguera, D. (2014). Fruits and vegetables: updating the epidemiologic evidence for the WCRF/AICR lifestyle recommendations for cancer prevention. In Advances in nutrition and cancer (pp. 35-50). Springer, Berlin, Heidelberg. https://link.springer.com/chapter/10.1007/978-3-642-38007-5_3
- Sagner, M., Katz, D., Egger, G., Lianov, L., Schulz, K. H., Braman, M., ... & Ornish, D. (2014). Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International journal of clinical practice, 68(11), 1289-1292. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ijcp.12509
- Shin, H. R., Joubert, C., Boniol, M., Hery, C., Ahn, S. H., Won, Y. J., ... & Mirasol-Lumague, M. R. (2010). Recent trends and patterns in breast cancer incidence among Eastern and Southeastern Asian women. Cancer Causes & Control, 21(11), 1777-1785. https://www.jstor.org/stable/pdf/40983459.pdf
- Sieri, S., Chiodini, P., Agnoli, C., Pala, V., Berrino, F., Trichopoulou, A., ... & Amiano, P. (2014). Dietary fat intake and development of specific breast cancer subtypes. JNCI: Journal of the National Cancer Institute, 106(5). DOI:10.1093/jnci/dju068
- Shiryazdi, S. M., Kholasehzadeh, G., Neamatzadeh, H., & Kargar, S. (2014). Health beliefs and breast cancer screening behaviors among Iranian female health workers. Asian Pac J Cancer Prev, 15(22), 9817-22. DOI:http://dx.doi.org/10.7314/APJCP.2014.15.22.9817
- Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet‐Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA: a cancer journal for clinicians, 65(2), 87-108. Doi: 10.3322/caac.21262
- Trichopoulou, A., Bamia, C., Lagiou, P., & Trichopoulos, D. (2010). Conformity to traditional Mediterranean diet and breast cancer risk in the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort–. The American journal of clinical nutrition, 92(3), 620-625. https://ajcn.nutrition.org/
- World Health Organization. (2013). Breast cancer: prevention and control. 2013. https://doi.org/10.7314/APJCP.2016.17.S3.43
- Wu, Y. C., Zheng, D., Sun, J. J., Zou, Z. K., & Ma, Z. L. (2015). Meta-analysis of studies on breast cancer risk and diet in Chinese women. International journal of clinical and experimental medicine, 8(1), 73. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358431/
- Wu, Y., Zhang, D., & Kang, S. (2013). Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast cancer research and treatment, 137(3), 869-882. DOI 10.1007/s10549-012-2396-7
References
Baglietto, L., Krishnan, K., Severi, G., Hodge, A., Brinkman, M., English, D. R., ... & Giles, G. G. (2011). Dietary patterns and risk of breast cancer. British journal of cancer, 104(3), 524-531. https://web.s.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=0&sid=7b49d9f3-d12d-454f-8753-ccb8418db281%40redis
Bray, F., Ren, J. S., Masuyer, E., & Ferlay, J. (2013). Global estimates of cancer prevalence for 27 sites in the adult population in 2008. International journal of cancer, 132(5), 1133-1145. https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.27711
Butler LM, Wu AH, Wang R, Koh W-P, Yuan J-M, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 2010;91(4):1013-1019. https://ajcn.nutrition.org/
Centers for Disease Control and Prevention (CDC. (2011). School health guidelines to promote healthy eating and physical activity. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 60(RR-5), 1. https://stacks.cdc.gov/view/cdc/6024
Collaborative Group on Hormonal Factors in Breast Cancer. (2012). Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. The lancet oncology, 13(11), 1141-1151. https://www.sciencedirect.com/science/article/pii/S1470204512704254
DeSantis, C., Ma, J., Bryan, L., & Jemal, A. (2014). Breast cancer statistics, 2013. CA: a cancer journal for clinicians, 64(1), 52-62. https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.3322/caac.21203
Ewertz, M., Jensen, M. B., Gunnarsdóttir, K. Á., Højris, I., Jakobsen, E. H., Nielsen, D., ... & Cold, S. (2010). Effect of obesity on prognosis after early-stage breast cancer. Journal of Clinical Oncology, 29(1), 25-31. https://ascopubs.org/doi/pdfdirect/10.1200/jco.2010.29.7614
Fan, L., Strasser-Weippl, K., Li, J. J., St Louis, J., Finkelstein, D. M., Yu, K. D., ... & Goss, P. E. (2014). Breast cancer in China. The lancet oncology, 15(7), e279-e289. https://doi.org/10.1016/S1470-2045(13)70567-9
Ferlay, J., Héry, C., Autier, P., & Sankaranarayanan, R. (2010). Global burden of breast cancer. In Breast cancer epidemiology(pp. 1-19). Springer, New York, NY. http://ndl.ethernet.edu.et/bitstream/123456789/48503/1/3439.pdf#page=13
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., ... & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359-E386. https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.29210
Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., ... & Bray, F. (2012). Lyon, France: International Agency for Research on Cancer; 2013. Cancer Incidence and Mortality Worldwide: IARC CancerBase, (10).
Ginsburg, O., Bray, F., Coleman, M. P., Vanderpuye, V., Eniu, A., Kotha, S. R., ... & Gralow, J. (2017). The global burden of women’s cancers: a grand challenge in global health. The Lancet, 389(10071), 847-860. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191029/
Hemminki, K., Mousavi, S. M., Sundquist, J., & Brandt, A. (2011). Does the breast cancer age at diagnosis differ by ethnicity? A study on immigrants to Sweden. The oncologist, 16(2), 146-154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228093/
Ibrahim, E. M., & Al-Homaidh, A. (2011). Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Medical oncology, 28(3), 753-765. DOI:10.1007/s12032-010-9536-x
Leong, S. P., Shen, Z. Z., Liu, T. J., Agarwal, G., Tajima, T., Paik, N. S., ... & Foulkes, W. D. (2010). Is breast cancer the same disease in Asian and Western countries?. World journal of surgery, 34(10), 2308-2324. https://link.springer.com/content/pdf/10.1007/s00268-010-0683-1.pdf
Li, Y., Zhang, T., Korkaya, H., Liu, S., Lee, H. F., Newman, B., ... & Sun, D. (2010). Sulforaphane, a dietary component of broccoli/broccoli sprouts, inhibits breast cancer stem cells. Clinical Cancer Research, 1078-0432. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862133/
Lin, C. H., Chen, Y. C., Chiang, C. J., Lu, Y. S., Kuo, K. T., Huang, C. S., ... & Cheng, A. L. (2012). The emerging epidemic of estrogen‐related cancers in young women in a developing Asian country. International journal of cancer, 130(11), 2629-2637. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.26249
Liu, L., Zhang, J., Wu, A. H., Pike, M. C., & Deapen, D. (2012). Invasive breast cancer incidence trends by detailed race/ethnicity and age. International journal of cancer, 130(2), 395-404. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.26004
Liu, X., & Lv, K. (2013). Cruciferous vegetables intake is inversely associated with risk of breast cancer: a meta-analysis. The Breast, 22(3), 309-313. https://www.sciencedirect.com/science/article/pii/S0960977612001646
Lynch, B. M., Neilson, H. K., & Friedenreich, C. M. (2010). Physical activity and breast cancer prevention. In Physical activity and cancer (pp. 13-42). Springer, Berlin, Heidelberg. DOI: 10.1007/978-3-642-04231-7_2
Naderimagham, S., Alipour, S., Djalalinia, S., Kasaeian, A., Noori, A., Rahimzadeh, S., ... & Farzadfar, F. (2014). National and sub-national burden of breast cancer in Iran; 1990-2013. Archives of Iranian Medicine (AIM), 17(12). http://journalaim.com/Article/747
Nelson, H. D., Zakher, B., Cantor, A., Fu, R., Griffin, J., O'meara, E. S., ... & Mandelblatt, J. S. (2012). Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Annals of internal medicine, 156(9), 635-648. https://doi.org/10.7326/0003-4819-156-9-201205010-00006
Norat, T., Aune, D., Chan, D., & Romaguera, D. (2014). Fruits and vegetables: updating the epidemiologic evidence for the WCRF/AICR lifestyle recommendations for cancer prevention. In Advances in nutrition and cancer (pp. 35-50). Springer, Berlin, Heidelberg. https://link.springer.com/chapter/10.1007/978-3-642-38007-5_3
Sagner, M., Katz, D., Egger, G., Lianov, L., Schulz, K. H., Braman, M., ... & Ornish, D. (2014). Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International journal of clinical practice, 68(11), 1289-1292. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ijcp.12509
Shin, H. R., Joubert, C., Boniol, M., Hery, C., Ahn, S. H., Won, Y. J., ... & Mirasol-Lumague, M. R. (2010). Recent trends and patterns in breast cancer incidence among Eastern and Southeastern Asian women. Cancer Causes & Control, 21(11), 1777-1785. https://www.jstor.org/stable/pdf/40983459.pdf
Sieri, S., Chiodini, P., Agnoli, C., Pala, V., Berrino, F., Trichopoulou, A., ... & Amiano, P. (2014). Dietary fat intake and development of specific breast cancer subtypes. JNCI: Journal of the National Cancer Institute, 106(5). DOI:10.1093/jnci/dju068
Shiryazdi, S. M., Kholasehzadeh, G., Neamatzadeh, H., & Kargar, S. (2014). Health beliefs and breast cancer screening behaviors among Iranian female health workers. Asian Pac J Cancer Prev, 15(22), 9817-22. DOI:http://dx.doi.org/10.7314/APJCP.2014.15.22.9817
Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet‐Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA: a cancer journal for clinicians, 65(2), 87-108. Doi: 10.3322/caac.21262
Trichopoulou, A., Bamia, C., Lagiou, P., & Trichopoulos, D. (2010). Conformity to traditional Mediterranean diet and breast cancer risk in the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort–. The American journal of clinical nutrition, 92(3), 620-625. https://ajcn.nutrition.org/
World Health Organization. (2013). Breast cancer: prevention and control. 2013. https://doi.org/10.7314/APJCP.2016.17.S3.43
Wu, Y. C., Zheng, D., Sun, J. J., Zou, Z. K., & Ma, Z. L. (2015). Meta-analysis of studies on breast cancer risk and diet in Chinese women. International journal of clinical and experimental medicine, 8(1), 73. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358431/
Wu, Y., Zhang, D., & Kang, S. (2013). Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast cancer research and treatment, 137(3), 869-882. DOI 10.1007/s10549-012-2396-7